U.S. patent number 8,556,626 [Application Number 13/671,269] was granted by the patent office on 2013-10-15 for mandible position indicator for measuring and replicating occlusion.
This patent grant is currently assigned to NorthPointe Holding Company LLC. The grantee listed for this patent is NorthPointe Holding Company LLC. Invention is credited to Roger A. Evenson.
United States Patent |
8,556,626 |
Evenson |
October 15, 2013 |
Mandible position indicator for measuring and replicating
occlusion
Abstract
One embodiments of the present subject matter include a method
that includes fixing a top pantograph to a patient via clutches to
the top teeth of the patient, fixing a bottom pantograph to a
patient via clutches to the bottom teeth of the patient, optically
monitoring the bite of the patient by monitoring the relation of
the top pantograph to the bottom pantograph during a bite cycle,
storing data relating to the actual bite storing patient data
including a three-dimensional model including a top teeth model and
a bottom teeth model, storing a digital top pantograph model
associated with the top pantograph, storing a digital bottom
pantograph model associated with the bottom pantograph, digitally
pairing the bite data, the top pantograph model and the bottom
pantograph model to the patient data, and digitally modeling the
bite.
Inventors: |
Evenson; Roger A. (Saint Paul,
MN) |
Applicant: |
Name |
City |
State |
Country |
Type |
NorthPointe Holding Company LLC |
Minnetonka |
MN |
US |
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Assignee: |
NorthPointe Holding Company LLC
(Minnetonka, MN)
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Family
ID: |
48427277 |
Appl.
No.: |
13/671,269 |
Filed: |
November 7, 2012 |
Prior Publication Data
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Document
Identifier |
Publication Date |
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US 20130130195 A1 |
May 23, 2013 |
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Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
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12714164 |
Feb 26, 2010 |
8348667 |
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61156373 |
Feb 27, 2009 |
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61619667 |
Apr 3, 2012 |
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Current U.S.
Class: |
433/68;
433/54 |
Current CPC
Class: |
A61C
19/052 (20130101); A61C 19/045 (20130101); A61C
9/0006 (20130101); A61B 5/0088 (20130101) |
Current International
Class: |
A61C
7/00 (20060101) |
Field of
Search: |
;433/54,56,57,68,69,73 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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WO-2008/080235 |
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Jul 2008 |
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WO |
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Other References
"U.S. Appl. No. 12/714,164, Response filed Aug. 20, 2012 to Ex
Parte Quayle Action mailed Jun. 20, 2012", 9 pgs. cited by
applicant .
"U.S. Appl. No. 12/714,164, Ex Parte Quayle Action mailed Jun. 20,
2012", 5 pgs. cited by applicant .
"U.S. Appl. No. 12/714,164, Notice of Allowance, mailed Sep. 7,
2012", 5 pgs. cited by applicant .
"U.S. Appl. No. 12/714,164, PTO Response to 312 Amendment mailed
Dec. 6, 2012", 2 pgs. cited by applicant .
"CONDYLOCOMP.RTM. LR3 Brochure", DENTRON GmbH, (Prior to Feb. 26,
2009), 4 pgs. cited by applicant.
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Primary Examiner: Lewis; Ralph
Attorney, Agent or Firm: Schwegman Lundberg & Woessner,
P.A.
Parent Case Text
CROSS-REFERENCE TO RELATED APPLICATIONS
This application is a continuation-in-part of U.S. patent
application Ser. No. 12/714,164, entitled "Mandible Position
Indicator and Automatic Articulator for Measuring and Replicating
Occlusion," filed Feb. 26, 2012, which claims the benefit of U.S.
Provisional Application No. 61/156,373, filed Feb. 27, 2009, the
disclosure of each of which is incorporated herein by reference in
its entirety.
This application claims the benefit of U.S. Provisional Application
No. 61/619,667, filed Apr. 3, 2012, the disclosure of which is
incorporated herein by reference in its entirety.
Claims
What is claimed is:
1. A method, comprising: fixing a top pantograph to a patient via
clutches to the top teeth of the patient; fixing a bottom
pantograph to a patient via clutches to the bottom teeth of the
patient; optically monitoring the actual bite of the patient by
monitoring the relation of the top pantograph to the bottom
pantograph during a bite cycle; storing bite data relating to the
actual bite; storing patient data including a three-dimensional
model including a top teeth model and a bottom teeth model; storing
a digital top pantograph model associated with the top pantograph;
storing a digital bottom pantograph model associated with the
bottom pantograph; digitally pairing the bite data, the top
pantograph model and the bottom pantograph model to the patient
data; and digitally modeling the bite by digitally moving the top
teeth model with respect to the bottom teeth model in association
with the stored bite data.
2. The method of claim 1, comprising replicating the actual bite
digitally using feedback by comparing the bite data relating to the
actual bite to the modeled bite.
3. The method of claim 1, wherein storing the bite data includes
communicating the bite data wirelessly to a measurement computer
and storing the data therein.
4. The method of claim 3, comprising storing a scan of the top
teeth and the bottom teeth in the measurement computer.
5. The method of claim 4, comprising displaying the bite on a
display of the measurement computer.
6. The method of claim 4, comprising storing a scan of the top
pantograph and the bottom pantograph.
7. The method of claim 3, including detecting a bite anomaly with
the measurement computer.
8. A method, comprising: fixing a top pantograph to a patient via
clutches to the top teeth of the patient; fixing a bottom
pantograph to a patient via clutches to the bottom teeth of the
patient; optically monitoring the actual bite of the patient by
monitoring the relation of the top pantograph to the bottom
pantograph during a bite cycle and storing a hinge axis; storing
data relating to the actual bite; scanning the top teeth to create
a top teeth model; scanning the bottom teeth to create a bottom
teeth model; digitally fitting a digital representation of the top
pantograph to the top teeth and a digital representation of the
bottom pantograph bottom pantograph to the bottom teeth; recording
the relationship of the top teeth model and the bottom teeth model
to the hinge axis; digitally creating a bite model by recording the
position of the top teeth model in relation to the bottom teeth
model while digitally moving the top teeth model with respect to
the bottom teeth model around the hinge axis.
9. The method of claim 8, comprising storing a scan of the top
teeth and the bottom teeth in a measurement computer.
10. The method of claim 9, comprising displaying the bite on a
display of the measurement computer.
11. The method of claim 9, including detecting a bite anomaly with
the measurement computer.
12. The method of claim 11, comprising flagging the bite anomaly
and displaying the flag.
13. The method of claim 9, comprising controlling an automatic
articulator with the measurement computer.
14. A system for modeling the bite of a digital top teeth model and
a digital bottom teeth model, comprising: a top pantograph having a
clutch to fit to a top row of teeth, the top pantograph including a
first sensor; a bottom pantograph having a clutch to fit to a
bottom row of teeth, the bottom pantograph including a second
sensor to communicate with the first sensor to record a physical
distance of the first sensor with respect to the second sensor
during a first time period; and a digital bite replicator to,
during a second time period, adjust a modeled location of the top
teeth model to a modeled location of the bottom teeth model to
replicate the physical distance of a digital model of the first
sensor with respect to a digital model of the second sensor.
15. The system of claim 14, comprising a computer to record the
physical distance of the first sensor with respect to the second
sensor during the first time period.
16. The system of claim 15, wherein the computer includes data
representative of a shape of the bottom teeth and the top teeth,
and is configured to display the orientation of the bottom teeth
with respect to the top teeth in association with the physical
distance of the first sensor with respect to the second sensor
during the first time period.
17. The system of claim 16, wherein the computer includes software
configured to detect a bite anomaly.
18. A system for analyzing the bite of a patient, comprising: a top
pantograph having a clutch to fit to a top row of teeth, the top
pantograph including a top bow and a first sensor; a bottom
pantograph having a clutch to fit to a bottom row of teeth, the
bottom pantograph including a bottom bow and a second sensor,
wherein the first sensor and the second sensor communicate to
measure a physical distance of the first sensor with respect to the
second sensor during a first time period, the first sensor and the
second sensor configured to provide a measured distance signal
including the measured distance; and a computer to store the
measured distance signal, the computer configured to display data
representing the top teeth and the bottom teeth during a second
time period other than the first, the computer configured to adjust
the location of the top teeth with respect to the bottom teeth to
replicate the physical distance of the first sensor with respect to
the second sensor during the second time period.
19. The system of claim 18, wherein the computer includes software
configured to detect a bite anomaly.
20. The system of claim 18, comprising an automatic Stewart
platform couplable to the top pantograph and the bottom pantograph
to, during a second time period, adjust the location of a first
cast of the top row of teeth to a second casting of the bottom row
of teeth to replicate the physical distance of the first sensor
with respect to the second sensor during a second time period other
than the first.
Description
BACKGROUND
Dental care providers may create a three dimensional ("3D")
physical model or cast of one or more areas of a patient's oral
cavity. With a 3D physical model, a care provider can interact with
the model to quickly view multiple angles of the model and to
visualize adjustments made to the model. For example, care
providers may create a model of an area of a patient's oral cavity
where one or more teeth are missing or damaged, so that suitable
replacement teeth may be made in the lab using the model as a
guide.
Proper fitting the lab-made teeth would benefit from an
understanding of how the teeth are used by the patient. In other
words, somehow linking the model to the mechanics of the patient's
bite is desirable. In the past, care providers have used a
mechanical device called an articulator in conjunction with the
models to replicate movement of the patient's mandible about a bite
axis. This is a crude replication of the bite and often fails to
capture intricacies of the bite motion, including habitual
adaptation of the bite to malformations of the teeth. Habitual
adaptation of the bite often occurs via muscle training In addition
to failing to capture the complex curvature of the bite, the known
methods are imprecise and inaccurate, as the care provider is often
mounted to soft tissue, record data via a pen, or introduce error
during different portions of a procedure. Articulators are manually
adjusted based on recorded data. This provides two windows for
errors. A third window for error is in model creation. What is
needed is a system which can accurately and precisely capture bite
motion and simulate bite motion so that a care provide can better
study bite motion. To reach a better understanding of a patient's
physiology and proposed care options, care providers have expressed
a desire to be able to study bite motion physically, rather than in
2 dimensions.
BRIEF DESCRIPTION OF THE DRAWINGS
The drawings illustrate generally, by way of example, various
embodiments discussed in the present document. The drawings are for
illustrative purposes only and may not be to scale.
FIG. 1 is an illustration of a digital bite information collection
apparatus 100, according to some embodiments.
FIGS. 2A-B illustrate clutches and a condylar axis, according to
some embodiments.
FIGS. 3A-C show a pantograph in two separate positions.
FIG. 4 illustrates a portion of a pantograph that includes a laser
402 that is split into a first beam 404 parallel the left-right
axis, and a second beam 406 parallel the dorsal-ventral axis,
according to some embodiments.
FIG. 5 illustrates an MMS 200, according to some embodiments. A
cast of the top teeth is coupled to the top bad 202, according to
some embodiments.
FIG. 6 illustrates an example system and method for transfer of bit
information to MMS without a jig, according to some
embodiments.
FIG. 7 illustrates a MMS, according to some embodiments.
FIG. 8 shows a further portion of an MMS, according to various
embodiments.
FIG. 9 illustrates a further MMS, according to some
embodiments.
FIG. 10 illustrates a table on which the device of FIG. 9 can be
mounted, to gain motion along axis A10, 1, according to some
embodiments.
FIG. 11 is a perspective view showing the underside of a bottom
articulator plate, according to some embodiments.
FIG. 12 illustrates a further MMS, according to some
embodiments.
FIG. 13 illustrates a perspective view of the capture plate 1208,
according to some embodiments.
FIG. 14 is a block diagram illustrating an example of a machine
upon which one or more embodiments may be implemented.
FIG. 15 is a method of modeling a bite, according to an
example.
FIG. 16 is a method of creating a bite model, according to an
example.
DETAILED DESCRIPTION
In the following description, reference is made to the accompanying
drawings that form a part hereof, and in which is shown by way of
illustration specific embodiments which may be practiced. These
embodiments are described in sufficient detail to enable those
skilled in the art to practice the invention, and it is to be
understood that other embodiments may be utilized and that
structural, logical and electrical changes may be made without
departing from the scope of the present invention. The following
description of example embodiments is, therefore, not to be taken
in a limited sense, and the scope of the present invention is
defined by the appended claims.
The present subject matter provides an improved system and method
for capturing dental articulation. It allows care providers to
understand articulation, create models of that articulation, find
improved articulation if possible, and provide treatments based on
the models that will either allow the existing articulation or
encourage the improved articulation.
The following benefits are recognized. First, the present subject
matter better captures bite motion by fixing measuring tools to
both the top and bottom teeth. This is preferred over systems that
fix to only one row of teeth, as it reduces error. Systems that fix
to only one row of teeth inevitably fix the other portion of a bite
monitoring system to soft tissue, which can result in error via
tissue movement or some other error. This problem is discussed
herein. Improvements over this approach by the present subject
matter include actually replicating the function of the condylar
axis, as well as eliminating the reliance on soft tissue or some
other error prone data in establishing the geometric relationship
of both rows of teeth to one another throughout a range of
mandibular articulations.
Second, the present subject matter better simulates motion by using
digital data to replicate a bite motion on an improved automated
articulator, which can include a Stewart platform. By recording
bite motion in a digital format, and then simulating the bite
motion using the digital motion, at least one opportunity for error
is eliminated. One opportunity for error is eliminated because data
from the monitor is transcribed to the articulator digitally,
rather than being replicated by hand adjustments to the
articulator.
FIG. 1 is an illustration of a digital bite information collection
apparatus 100, according to some embodiments. The system includes a
top face bow 102 coupled to a top clutch 106. The top clutch can be
coupled to a top teeth and optionally gingivia of a patient, such
as by using a quick setting, compliant compound that can both
capture the shape of the teeth and which can be released from the
teeth. The system 100 further includes a bottom face bow 104
coupled to a bottom teeth 108, which can have a compound disposed
in it just as the top face bow 102 does.
When mounted, the care provided can adjust the face bows 102, 104
so that a first sensor 110 registers with both an
anterior-posterior sensor field 112 and a horizontal sensor field
114. This adjustment can optionally be performed using adjustable
sliders 150A-D. This allows the tool to fit to persons in different
stages of development.
The first sensor 110 is a laser in some embodiments, but the
present subject matter is not so limited. Other optical sensors can
be used. The sensor fields can include position sensitive diodes
("PSDs"), but the present subject matter is not so limited. To save
cost, the illustrated embodiment uses a laser splitter to direct
laser light from one laser to both sensor fields 112, 114, but the
present subject matter is not so limited.
FIGS. 2A-B illustrate clutches and a condylar axis, according to
some embodiments. The present subject matter accurately and
precisely captures D1 and D1 by running the laser, broadcasting
laser light against a sensor plane, and digitizing and storing the
information captured digitally in a measurement computer for
analysis and display.
FIGS. 3A-B show a pantograph in tow separate positions. As the
patient moves their mandibles from the position illustrated in FIG.
3A to the position illustrated in FIG. 3B, the lasers trace a path
118 of laser light against a plurality of sensor planes, and this
path is captured digitally. The precision is to at least 0.0001 of
an inch. This path can be in the anterior-posterior/dorsal-ventral
plane, and/or it can be in the anterior-posterior/left-right plane,
as illustrated by the path 130 traced in FIG. 3C. This is an
improvement over systems that use styluses and pens which have to
be changed after each recording. This approach allows for iterative
captures, which can statistically improve certainty that the path
of interest is desired. This information is used to study the
patient and to provide therapy to the patient. In some embodiments,
a measurement computer monitors data and issues an alert to a care
provider when a specific degree of statistical certainty so to the
arc of the jaw is determined.
FIG. 4 illustrates a portion of a pantograph that includes a laser
402 that is split into a first beam 404 parallel the left-right
axis, and a second beam 406 parallel the dorsal-ventral axis.
Adjustments can be made using one or more thumb screws (or some
analog) to move the laser in relation to a second pantograph along
one or both of the 4X axis and the 4Y axis.
Axis of Rotation, Excursions, "Natural Path"
One procedure contemplated herein studies mandibular function. This
procedure is useful to understand the bite bath as mandated by the
condyle, and not the teeth. This "natural path" is the path that
would be experienced but for teeth interfering with the bite.
During approximately 20 to 25 mm of opening or closing of the mouth
from and to contact of the teeth, the mandible rotates around an
axis of rotation A1, which is located in the condyle. This is often
referred to as a "hinge movement," and therefore, this axis is
called the "hinge axis." When the condyles are in their
anterior-superior, "seated" position in the mandibular fossae, this
axis is called the "terminal hinge axis." This is understood to be
the physiologic position from which "mandibular movements" or
"excursions" start. A "mandibular movement" might be opening the
mouth, moving the mandible in an anterior direction or moving the
mandible in a right or left excursive movement.
The teeth of some patients are arranged such that when they bite in
their normal, day to day occlusion (intercuspal position or
habitual occlusion), the condyles are in the normal,
anterior-superior location in the mandibular fossa and therefore,
the axis of rotation is also in the normal location. However, one
problem is that the teeth of some patients are arranged such that
when they bite in their normal day-to-day occlusion, the condyles
are not in the anterior-superior location in the mandibular fossae,
and therefore the axis of rotation is at some variance from that
which is considered physiologic.
The problem noted above becomes more obvious when the person
experiences a related "problem" in the form of "muscle splinting"
or cramping. When the occlusion is not in harmony with the
physiologic position of the condyles, the muscles must move the
mandible to the position where their teeth will bite in their
normal day today bite (habitual occlusion). If the muscle activity
is beyond their capacity to tolerate this function, they start to
hurt.
A second problem occurs if the person's axis of rotation is located
at some variance from the desired location. When the mandible is
moved in a lateral excursion, the patient moves in a habitual
pathway that works. The muscles navigate the mandible in the
pathway in which "interferences" or obstacles do not occur.
However, during sleep or at various times such as resting with the
teeth slightly apart, the condyles tend to seat in their
physiologic position, and then when the mandible moves in an
excursion, or the "natural path," a problem occurs in that the
teeth experience "interferences," or problematic tooth contacts.
This results in abnormal tooth wear, called "facets." If severe,
these interferences result in bone loss, a need for a "root canal
treatment," muscle splinting, temporomandibular joint disorders and
other problems. Patients attempt to counter these afflictions
through habitual adaptation, i.e. muscle training.
A problem also can occur during the treatment process of
fabricating and placing a prosthetic dental item, such as a crown
or a bridge. If the occlusal (biting surface of a tooth) surface of
a gold or porcelain crown is not designed and formed in a manner
that provides for both the habitual and physiologic (natural)
function, the patient may experience difficulty in the form of
tooth pain, muscle pain, tm joint paint and headaches. Therefore,
in addition to simple day-to-day function problems, there is the
potential for treatment problems if a dental provider does not
address the matters of axis of rotation and excursive mandibular
movement.
If a dental provider is treating the entire occlusion, then it is
mandatory that the axis of rotation, or hinge axis is located,
recorded and transferred to an appropriate instrument on which the
prosthetic item is to be fabricated. The present subject matter
performs this function.
Some instruments do not locate the axis of rotation accurately and
are difficult and time consuming to use. In addition, quite often
an instrument is used to determine an "arbitrary" or "estimated"
axis of rotation. In this method, some device is used to locate a
point 13 mm anterior to the tragus of the ear on a line from the
tragus to the outer canthus of the eye. This has been determined to
approximate the location of the axis of rotation. The problem is
that this is only a poor estimation of the actual axis of rotation,
and it could vary from one-half a millimeter to two or three
millimeters. There will always be some degree of error when an
"estimated axis" is used. Therefore, it is critical to accurately
locate the physiologic axis of rotation when treating the entire
occlusion with a full-mouth reconstruction, orthodontic treatment
or any treatment that involves the entire occlusion. Known
solutions are inaccurate, difficult to use and consume an
inordinate amount of time in use. The present subject matter
addresses these problems.
One way the present subject matter addresses these problems is by
allowing the care provider to understand the natural path and the
habitual path in operation of an articulator. The present subject
matter, through tooth scans, can digitize bite motion and store and
display that on a measurement computer, in conjunction with an
actual bite. This could be done by replacing the adjusters 150 with
linear distance monitors. Then a measurement computer would have
scanned teeth and would understand the bite via data received from
the system 100.
The present subject matter additionally allows modeling of natural
path and habitual path via an 3D bench top articulator. This
articulator, as disclosed herein in relation to various
embodiments, uses servo motors to move the mandibles in relation to
one another to simulate a bite via the methods set out above.
Centric Relation Bite Registration
If the patient has soreness or pain in the muscles of mastication
or if the patient has a temporomandibular ("TM") joint disorder,
one should resolve those problems prior to attempting to accomplish
a centric relation bite registration. One can to the bite
registration, but it most likely will not be accurate.
The process for resolving muscle soreness or pain or symptoms of a
TM joint disorder may involve the use of an occlusal splint (a
plastic device that fits over the teeth to provide proper occlusion
function in order to allow healing) for several months. Other
measures such as physical therapy may be involved as well.
If the patient does not have soreness or pain of the muscles of
mastication and does not have a TM joint disorder or if the patient
has had these problems resolved, then one proceeds with the bite
registration, which is described below.
In using the anterior stop technique, one can prepare a four
thickness piece of occlusion wax that provides for the width of the
maxillary anterior teeth and that provides for contact with the
mandibular incisors. Generally, this piece of wax will be 11/2
inches long, 1/2 to 3/4 inches wide and 1/2 inches deep. Heat the
wax in a water bath at 140 degrees.
Prepare a two thickness piece of occlusion wax (the posterior
piece) that provides for the width of the maxillary first molars at
their buccal surface. Generally, this piece of wax will be 3 to 4
inches long, 1 inch wide and 3/8 inches deep. Heat the wax in a
water bath at 140 degrees.
Attached the system 100 to the patient. After instruction the
patient regarding the procedure, place the dead soft anterior piece
of wax on the maxillary anterior teeth. With the thumb on the
patient's chin, the index finger under the left gonial angle of the
mandible and the middle finger under the right gonial angle of the
mandible, manipulate the patient's mandible to cause an arcing
motion of four to eight millimeters while applying only an upward
pressure at the gonial angles. As this is being accomplished, one
should feel the mandible seating in "rest position," or that
position of the mandible one would find it to be when the muscles
of mastication are not active. The purpose of the upward pressure
is only to sense if the patient moves the mandible out of rest
position. The manipulation must start at rest position and the
condyles must not be allowed to move out of their seated position.
As this is being accomplished, one will note a smooth and freely
arcing motion to the mandible. The patient is instructed to let the
lower incisors strike the wax. Then the patient is instructed to
"squeeze" and "bite slowly." The care provider instructs the
patient to stop biting when the maxillary and mandibular posterior
teeth are about 11/2 to 2 millimeters from contact. The posterior
teeth cannot contact at any point or the patient will move the
mandible to their habitual occlusion and the bite registration is
invalid. If the procedure is satisfactory, the anterior wax piece
is cooled with air from an air syringe, the piece is held in place
while the patient is instructed to open, and the wax piece is place
in ice water.
After the anterior wax piece has hardened in the ice water, the
dead soft posterior wax piece is placed on the maxillary first
molars, extending across the palate. The wax is pressed onto the
occlusal surface and held in place. Then the cold, hard anterior
wax piece is replaced on the maxillary anterior teeth.
Optionally, the wax is coupled to the clutches 104, 106 so that the
system 100 can record the relation of the teeth to the axis when
the system is engaged to record. One input to record could be a
foot pedal, but the present subject matter is not so limited.
During a recording period, the care provider places the fingers on
the chin and the gonial angles as before and manipulates the
mandible in the same manner, watching carefully to be certain the
mandibular incisors fit into the registration imprints in the
wax.
If the incisors fit, during another recording period, the patient
is told to "squeeze" and then "bite hard evenly on both sides."
During this biting, the muscles of mastication (primarily the
masseter and internal ptyergoid muscles) seat the condyles in a
physiologic, seated position, which is understood to be in a
superoanterior location in the mandibular fossae. This position can
be recorded.
The posterior wax piece is cooled with air from the air syringe,
the posterior piece is held against the maxillary molars and the
patient is instructed to "open." The anterior and posterior wax
pieces are floated in water to prevent distortion. The centric
relation wax bite registration (2 pieces) together with a proper
transfer of the condylar axis via the system 100 are used to mount
the dental models in one or more dental articulators.
Centric relation is defined as the relative location of the
mandible when the condyles and their properly attached articular
discs are actively positioned by the closing musculature against
the superoanterior areas of the posterior slopes of the articular
eminences of the mandibular fossae and are also physiologically
positioned transversely.
The models are "mounted in centric relation." This is an improved
mount. When combined with the improved determination of the
condylar axis as set out herein, including but not limited to
excursion and path data from the system 100, superior and highly
accurate and precise representation on an articulator can take
place.
Systems and Methods for Recording Mandibular Movement
A care provider can select clutches, upper, and lower. The care
provider can fill upper and lower clutches with medium such as a
wax. The care provider can fit the clutches to respective teeth. In
optional embodiments, the care provider can align right and left
sensor ear canal indicators to ear canals. In some embodiments, the
care provider can fit lower clutch in alignment to upper clutch. In
some embodiments, the care provider can fasten upper face bow to
upper clutch, aligning in a horizontal plane. In some embodiments,
the care provider can fasten lower face bow to lower clutch,
aligning in a horizontal plane. In optional embodiments, the care
provider can align right and left lasers to indicators.
In various embodiments, the care provider can power on a
measurement computer, upper face bow and lower face bow and check
all lasers and PSD sensors function and wireless communication with
the measurement computer. In some embodiments, the care provider
can position a patient in chair in upright sitting position. In
some embodiments, the care provider can instruct patient to make
random movement to test system function. In some embodiments, the
care provider can have patient open and close their jaw several
times while recording using the laser. In some embodiments, the
care provider can check to see if hinge recordings, right and left
sensors overlap. If not, in some embodiments, the care provider can
optionally erase recordings and repeat hinging until the recordings
overlap. The care provider may be able to erase recordings and
repeat hinge only once. The system can optionally calibrate so that
the hinge arcs substantially overlap (e.g., less than 5% different
in amplitude along arc).
In various embodiments, the care provider can check arcs described
by laser-on-sensors on, for example, a monitor. The arcs could
optionally be stored in a memory for use by another device, such as
a processor in a Mandibular Movement Simulator ("MMS") computer, as
disclosed herein. In some embodiments, the care provider can query
the measurement computer to show origin of arc radii with, for
example, a blinking dot or target. In some embodiments, the care
provider can repeat operation with different color dot to confirm
duplicate result. The measurement computer could also duplicate the
result or calculate statistical certainty via a number of
iterations.
In some embodiments, the care provider can reposition horizontal
laser beams, right, and left, to arc radii origins, as indicated
and verified by the measurement computer. In some embodiments, the
care provider can reposition vertical sensors on right and left
sides of pantograph to align axial centers on sensors, to be
coaxial with laser beams as indicated and verified on the
measurement computer display and/or via a reoccurring sound that
increases in frequency as the tool is moved into adjustment. In
some embodiments, the care provider can choose to magnify result on
monitor, and query the measurement computer if any errors, or
anomalies are indicated. If there are anomalies, the care provider
could store them with a flag. If they do not, the care provider may
have the patient make several protrusive movements while recording,
and save those recordings.
In various embodiments, the care provider may have patient make
several passes of right excursive movement, while recording.
Optionally, they can check if recordings overlap. If they do not,
the care provider can troubleshoot by checking equipment and
adjusting or calibrating either the sensors in relation to one
another or the pantograph in relation to the patent. The care
provider can optionally make a note and save that note in relation
to the record. Also, they can have patient make several passes of
left excursive movement, while recording. The care provider may
check if recordings overlap. If they do not, the care provider may
troubleshoot. If they do, the care provider may note this and save
the data relating to success and to the actual motion in a database
in relation to the note.
The care provider may remove upper face bow, with clutch intact and
set it aside. The care provider may remove lower face bow, with
clutch intact and set it aside. They can take impressions of upper
and lower arches. They can pour upper and lower impressions with
hard stone and trim.
Jig System and Method
They can mount upper an pantograph bow to a Mandibular Movement
Simulator ("MMS") mounting jig. They can mount lower pantograph bow
to MMS the mounting jig. The lasers are aligned to targets (e.g.,
sensors) on the jig. The upper and lower pantograph bows can
optionally be locked together. The care provider replaces the upper
and lower clutches into respective positions in the pantographs.
Use pantograph to mount upper and lower trimmed stone casts to the
Mandibular Movement Simulator mounting jig. At this point, the
casts are mounted in a jig, and condylar axis data is also stored
on the jig. This jig could be fit to a hand articulator and used to
align the casts to that articulator.
Optionally, the care provider can transfer mounted casts or molds
to an MMS. This is a device that is controllable in 6 axes to
simulate mandibular movement. In other words, the machine can
adjust the lower mandible via servo motors. The adjustment can be
along the anterior-posterior axis, around that axis, along the
dorsal axis and around that axis, and along the left-right axis and
around. The hinge axis is substantially parallel to the left-right
axis.
The upper and lower pantographs can be attached to the jig during
the transfer, or they can be used to store data relating the
location of the hinge axis to the jig. Once this dimension is
known, the jig can then be coupled to the MMS and the MMS can be
calibrated to replicate movement according to the axis transported
with the jig. This way, the care provider does not have to buy two
sets of pantographs and can leave one at the measurement location
and still replicate the motion at the MMS. If the care giver has
one or more hand articulators, she can mount the jigs of different
patients to different articulators and reconstructive work can be
done for multiple patients simultaneously.
System and Method for Transfer to MMS without Jig
In an additional embodiment, one that can eliminate the error
associated with transfer of the hinge axis location information
from the measurement site, to a jig, and to the MMS, one can simply
mount casts to the MMS, fit the pantographs to the MMS and the
casts, and then have the MMS cycle through motions until it can
replicate the arc data that's been stored in the measurement
computer from the pantographs. It would do this using feedback. For
example, if the laser does not record a path that overlaps with the
stored bite path, the simulated path is adjusted, until the
simulated path replicates the stored path within a specified degree
of tolerance.
MMS Algorithms
The MMS is a multi-mode system. Modes are selectable by a user to
perform different functions. In various embodiments, the MMS can be
controlled to execute a program stored on the MMS computer to
simulate natural paths. In a further mode, it can be controlled to
simulate habitual paths. In a further mode, it can be controlled to
find a simulated habitual path by starting with a natural path and
forcing teeth to collide with one another.
In measuring bite, to find a natural path, habitual paths should be
suppressed. If a patient has habitual paths, one or more of the
following methods can be used to erase it from the patient's muscle
memory: the patient can be numbed, or can have their jaw locked
together, or their bit modified with a splint. Once the bite is
restore it to a natural path, it can be recorded.
In embodiments where natural path is simulated, using the hinge
axis as a reference, the MMS is operated to explore a normal range
of mandibular motion. The care giver can study the look of the mold
as the system ranges through this motion. Restorations can be made,
and one can ensure that the natural path is preserved.
In additional embodiments, the care provider can execute a program
stored on the MMS computer to find and record habitual paths. In
this algorithm, the MMS attempts to move a casting through natural
motions as determined during measurement. Interferences will be
bumped into and recorded. The machine will attempt new paths, and
can report progress to the care provider. This attempt to find new
paths will simulate the patient's effort to find habitual
paths.
The MMS can move the castings through a natural path set of
predetermined motions to determine what the habitual path is. This
can optionally be correlated with a predetermined habitual path
that is measured with a wax bite or with the system 100, above.
As the habitual paths are found, the care provider can modify the
teeth of the cast to eliminate the need for the habitual path. This
can aid in the creation of improved restorations. The 3D nature of
the process assists the care provider in modifying the casts by
hand, which can save time and money. Habitual paths that are
determined can be stored in the MMS computer or elsewhere for later
review.
FIG. 5 illustrates an MMS 200, according to some embodiments. A
cast of the top teeth is coupled to the top bad 202. A cast of the
bottom teeth is coupled to the bottom pad 204. The servo box 206
contains servos to move these pads in relation to one another along
up to six degrees of freedom.
FIG. 6 illustrates an example system and method for transfer of bit
information to MMS without a jig. In them embodiments, the system
100 is fitted to casts 208 and 210 that are coupled to the MMS. The
pantographs are moved in relation to each other, and the laser 110
broadcasts a beam to sensor fields 112 and 114. The MMS can thus
learn how to replicate the measured bite motion by trying to model
(e.g., curve fit) data monitored from motion of the MMS to stored
data, and adjusting the motion of the MMS accordingly.
FIG. 7 illustrates a MMS 700, according to one embodiment. The
motors 304, 306 and 308 move the bottom plate, to which a cast is
mounted, along A71, A72 and A73, among others. The guide 302
supports rotation. In some embodiments, the guide 302 includes a
bushing.
FIG. 8 shows a further portion of an MMS, according to various
embodiments. The system can move at least along axis A81, A82 and
A83. Bearings 802, 804 and 806 support such rotation. A fixture 810
is coupled to the MMS to provide further rotation ability.
FIG. 9 illustrates a further MMS 900, according to some
embodiments. The MMS includes linear motors 904, 906, 908 and 910.
The system moves the bottom articulator plate 902, to which a cast
is coupled, free to move along the six degrees of freedom discussed
above. A spherical joint 914 and hinge joints 916 are coupled to
the articulator plate 902 and assist in motion.
FIG. 10 illustrates a table on which the device of FIG. 9 can be
mounted, to gain motion along axis A10, 1. Motion, in some
examples, occurs via actuation of motor 904 to move along the axis.
Linear motors 904 and 906 as well as hinge joints 916 are
illustrated coupled to bottom plate 902.
FIG. 11 is a perspective view showing the underside of a bottom
articulator plate, according to some embodiments. The general
concavity of the bottom plate 902, on a side not shown, is further
illustrated.
FIG. 12 illustrates a further MMS, according to some embodiments.
The device is show in cross section. In some embodiments, the
device is symmetrical about the cross section. A tilt shaft 1202
can move in relation to support ring 1204 to adjust the mount plate
1206 in relation to the support ring 1204. In various embodiments,
a capture plate 1208 is to pinch the support ring by drawing the
mount plate 1206 to the capture plate 1208, with the support ring
in the middle. In various embodiments, the support ring has a
concavity to contain the mount plate, to which a cast is coupled.
Accordingly, the support ring 1204 is shaped like a sphere portion,
and the mount plate 1206 and capture plate 1208 are conformed to
the support ring 1204 to slide along the support ring 1204 while
maintaining contact with the support ring.
FIG. 13 illustrates a perspective view of the capture plate 1208,
according to some embodiments. The support ring's concavity 1302 is
shown.
The tilt shaft 1202 can optionally be threaded, with the capture
plate 1208 threaded onto the tilt shaft 1202. FIGS. 12-16
illustrate further views of the components of FIG. 12.
FIG. 14 illustrates a block diagram of an example circuit 1400
which can be used in conjunction with any of the examples discussed
herein. The circuit 1400 can operate as a standalone device or can
be connected (e.g., networked) to other circuits. The circuit 1400
can form all or a part of a personal computer (PC), a tablet PC, a
set-top box (STB), a Personal Digital Assistant (PDA), a mobile
telephone, a web appliance, a network router, switch or bridge, or
any machine capable of executing instructions (sequential or
otherwise) that specify actions to be taken by that machine. The
term "circuit" can include any collection of circuits that
individually or jointly execute a set (or multiple sets) of
instructions to perform any one or more of the systemologies
discussed herein, such as cloud computing, software as a service
(SaaS), other computer cluster configurations. Insofar as circuit
embodiments include software, such software can reside on a machine
readable medium. Software, when executed by hardware, can cause the
hardware to perform a function.
Circuit (e.g., computer system) 1400 can include a hardware
processor 1402 (e.g., a central processing unit (CPU), a graphics
processing unit (GPU), a hardware processor core, or any
combination thereof), a main memory 1404 and a static memory 1406,
some or all of which can communicate with each other vian an
interlink (e.g., bus) 1408. The circuit 1400 can further include a
display unit 1410, an alphanumeric input device 1412 (e.g., a
keyboard), and a user interface (UI) navigation device 1414 (e.g.,
a mouse). The display unit 1410, input device 1412 and UI
navigation device 1414 can be a touch screen display. The circuit
1400 can additionally include a storage device (e.g., drive unit)
1416, a signal generation device 1418 (e.g., a speaker), a network
interface device 1420, and one or more sensors 1421, such as a
global positioning system (GPS) sensor, compass, accelerometer, or
other sensor. The circuit 1400 can include an output controller
1428, such as a serial (e.g., universal serial bus (USB), parallel,
or other wired or wireless (e.g., infrared (IR), near field
communication (NFC), etc.) connection to communicate or control one
or more peripheral devices (e.g., a printer, card reader,
etc.).
The storage device 1416 can include a machine readable medium 1422
on which is stored one or more sets of data structures or
instructions 1424 (e.g., software) embodying or utilized by any one
or more of the techniques or functions described herein. The
instructions 1424 can also reside, completely or at least
partially, within the main memory 1404, within static memory 1406,
or within the hardware processor 1402 during execution thereof by
the circuit 1400. In an embodiment, one or any combination of the
hardware processor 1402, the main memory 1404, the static memory
1406, or the storage device 1416 can constitute machine readable
media.
While the machine readable medium 1422 is illustrated as a single
medium, the term "machine readable medium" can include a single
medium or multiple media (e.g., a centralized or distributed
database, and/or associated caches and servers) that configured to
store the one or more instructions 1424.
The term "machine readable medium" can include any medium that is
capable of storing, encoding, or carrying instructions for
execution by the circuit 1400 and that cause the circuit 1400 to
perform any one or more of the techniques of the present
disclosure, or that is capable of storing, encoding or carrying
data structures used by or associated with such instructions.
Non-limiting machine readable medium embodiments can include
solid-state memories, and optical and magnetic media. In an
embodiment, a massed machine readable medium comprises a machine
readable medium with a plurality of particles having resting mass.
Specific embodiments of massed machine readable media can include:
non-volatile memory, such as semiconductor memory devices (e.g.,
Electrically Programmable Read-Only Memory (EPROM), Electrically
Erasable Programmable Read-Only Memory (EEPROM)) and flash memory
devices; magnetic disks, such as internal hard disks and removable
disks; magneto-optical disks; and CD-ROM and DVD-ROM disks.
The instructions 1424 can further be transmitted or received over a
communications network 1426 using a transmission medium via the
network interface device 1420 utilizing any one of a number of
transfer protocols (e.g., frame relay, internet protocol (IP),
transmission control protocol (TCP), user datagram protocol (UDP),
hypertext transfer protocol (HTTP), etc.). Embodiment communication
networks can include a local area network (LAN), a wide area
network (WAN), a packet data network (e.g., the Internet), mobile
telephone networks (e.g., cellular networks), Plain Old Telephone
(POTS) networks, and wireless data networks (e.g., Institute of
Electrical and Electronics Engineers (IEEE) 802.11 family of
standards known as Wi-Fi.RTM., IEEE 802.16 family of standards
known as WiMax.RTM.), peer-to-peer (P2P) networks, among others.
The network interface device 1420 can include one or more physical
jacks (e.g., Ethernet, coaxial, or phone jacks) or one or more
antennas to connect to the communications network 1426. The network
interface device 1420 can include a plurality of antennas to
wirelessly communicate using at least one of single-input
multiple-output (SIMO), multiple-input multiple-output (MIMO), or
multiple-input single-output (MISO) techniques. The term
"transmission medium" shall be taken to include any intangible
medium that is capable of storing, encoding or carrying
instructions for execution by the circuit 1400, and includes
digital or analog communications signals or other intangible medium
to facilitate communication of such software.
The example circuit 1400 can include a digital bite replicator. The
example circuit 1400 can include a computer such as to store a
measured distance. Sensors 1421 can include sensors 110 in FIG. 1.
Examples herein provide a digital dental diagnostic system.
FIG. 15 is a method 1500 of modeling a bite, according to an
embodiment. At 1502, the method can include fixing a top pantograph
to a patient via clutches to the top teeth of the patient. At 1504,
the method can include fixing a bottom pantograph to a patient via
clutches to the bottom teeth of the patient. At 1506, the method
can include optically monitoring the actual bite of the patient by
monitoring the relation of the top pantograph to the bottom
pantograph during a bite cycle. At 1508, the method can include
storing bite data relating to the actual bite. At 1510, the method
can include storing patient data including a three-dimensional
model including a top teeth model and a bottom teeth model. At
1512, the method can include storing a digital top pantograph model
associated with the top pantograph. At 1514, the method can include
storing a digital bottom pantograph model associated with the
bottom pantograph. At 1516, the method can include digitally
pairing the bite data, the top pantograph model and the bottom
pantograph model to the patient data. At 1518, the method can
include digitally modeling the bite by digitally moving the top
teeth model with respect to the bottom teeth model in association
with the stored bite data.
FIG. 16 is a method 1600 of creating a bite model, according to an
embodiment. At 1602, the method can include fixing a top pantograph
to a patient via clutches to the top teeth of the patient. At 1604,
the method can include fixing a bottom pantograph to a patient via
clutches to the bottom teeth of the patient. At 1606, the method
can include optically monitoring the actual bite of the patient by
monitoring the relation of the top pantograph to the bottom
pantograph during a bite cycle and storing a hinge axis. At 1608,
the method can include storing data relating to the actual bite. At
1610, the method can include scanning the top teeth to create a top
teeth model. At 1612, the method can include scanning the bottom
teeth to create a bottom teeth model. At 1614, the method can
include digitally fitting a digital representation of the top
pantograph to the top teeth and a digital representation of the
bottom pantograph bottom pantograph to the bottom teeth. At 1616,
the method can include recording the relationship of the top teeth
model and the bottom teeth model to the hinge axis. At 1618, the
method can include digitally creating a bite model by recording the
position of the top teeth model in relation to the bottom teeth
model while digitally moving the top teeth model with respect to
the bottom teeth model around the hinge axis.
Optional methods can include replicating the actual bite digitally
using feedback by comparing the bite data relating to the actual
bite to the modeled bite. Optional methods can include storing the
bite data includes communicating the bite data wirelessly to a
measurement computer and storing the data therein. Optional methods
can include storing a scan of the top teeth and the bottom teeth in
the measurement computer. Optional methods can include storing a
scan of the top pantograph and the bottom pantograph. Optional
methods can include displaying the bite on a display of the
measurement computer. A display can include output readable by a
computer. A display can include a visible display such as a video
screen. Optional methods can include detecting a bite anomaly with
the measurement computer. Optional methods can include flagging the
bite anomaly and displaying the flag. Optional methods can include
controlling an automatic articulator with the measurement
computer.
The above detailed description includes references to the
accompanying drawings, which form a part of the detailed
description. The drawings show, by way of illustration, specific
embodiments in that may be practiced. These embodiments are also
referred to herein as "examples." Such examples can include
elements in addition to those shown or described. However, the
present inventors also contemplate examples in which only those
elements shown or described are provided. Moreover, the present
inventors also contemplate examples using any combination or
permutation of those elements shown or described (or one or more
aspects thereof), either with respect to a particular example (or
one or more aspects thereof), or with respect to other examples (or
one or more aspects thereof) shown or described herein.
All publications, patents, and patent documents referred to in this
document are incorporated by reference herein in their entirety, as
though individually incorporated by reference. In the event of
inconsistent usages between this document and those documents so
incorporated by reference, the usage in the incorporated
reference(s) should be considered supplementary to that of this
document; for irreconcilable inconsistencies, the usage in this
document controls.
In this document, the terms "a" or "an" are used, as is common in
patent documents, to include one or more than one, independent of
any other instances or usages of "at least one" or "one or more."
In this document, the term "or" is used to refer to a nonexclusive
or, such that "A or B" includes "A but not B," "B but not A," and
"An and B," unless otherwise indicated. In the appended claims, the
terms "including" and "in which" are used as the plain-English
equivalents of the respective terms "comprising" and "wherein."
Also, in the following claims, the terms "including" and
"comprising" are open-ended, that is, a system, device, article, or
process that includes elements in addition to those listed after
such a term in a claim are still deemed to fall within the scope of
that claim. Moreover, in the following claims, the terms "first,"
"second," and "third," etc. are used merely as labels, and are not
intended to impose numerical requirements on their objects.
The above description is intended to be illustrative, and not
restrictive. For example, the above-described examples (or one or
more aspects thereof) may be used in combination with each other.
Other embodiments can be used, such as by one of ordinary skill in
the art upon reviewing the above description. The Abstract is
provided to comply with 37 C.F.R. .sctn.1.72(b) to allow the reader
to quickly ascertain the nature and gist of the technical
disclosure. The Abstract is submitted with the understanding that
it will not be used to interpret or limit the scope or meaning of
the claims. Also, in the above Detailed Description, various
features may be grouped together to streamline the disclosure. This
should not be interpreted as intending that an unclaimed disclosed
feature is essential to any claim. Rather, inventive subject matter
may lie in less than all features of a particular disclosed
embodiment. Thus, the following claims are hereby incorporated into
the Detailed Description, with each claim standing on its own as a
separate
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